Page 15 - Routines-Based Early Intervention Guidebook

Routines-Based Early Intervention Guidebook

syllable words or phrases. For example, if the child is producing “nana,” a logical next step
might be for him to produce “banana.” This could also be targeted in phrases by combining the
child’s words with one other simple word. For example, if the child is already saying the word
“mi” (my), we could target phrase such as “mi mamá” (my mommy) or “mi bebé” (my baby).
Again, this is about building and shaping speech produc on skills. Sudden jumps in complexity
that are too far from the child’s current abili es can o en be met with frustra on.

What are speech produc on difficul es?

When children’s difficul es with speech produc on are more severe, this process of
slowly building and shaping the child’s produc ons by following developmental pa erns
becomes even more crucial. Children whose speech produc on differs from their peers are
either delayed in their speech produc on or have atypical speech produc on abili es.
Delayed speech produc on implies that children are following the same developmental course
as children with typical development but at a later age. In other words, they produce earlier
sounds, such as “b” and “m,” before later sounds, such as “r” and “l.” Children with atypical
speech produc on do not follow a typical developmental sequence. For example, children
with cle lip and palate do not acquire oral plosive sounds (i.e., “p” and “b”) early in
development as a result of structural abnormali es. The type of speech produc on difficulty a
child has requires careful a en on to which targets we choose, and how we work on those
targets.

Included in every session, there is a section called “My Child Will,” where the
interventionist and family can state their goal for the child in terms of speech and/or language
production. When children need speech production difficulties to be addressed more
specifically, this can be done through the use of speech bubbles that are labeled “Therapist
Suggests.” In this space, the speech‐language pathologist can make suggestions for additional
cueing or modeling strategies to help children improve in this area as well. Examples of how
to integrate these strategies within the SMILE framework are also available in the Appendix of
this book.

What strategies can we use to facilitate speech produc on?

Cueing:

We o en use mul sensory cueing. This is a technical term for helping the child
produce sounds by incorpora ng the use of many of their senses. Specifically, we use visual,
tac le, motor, and auditory cues. The goal is to gradually fade these cues as the child becomes
more successful in producing the target sound. Below we discuss each of the mul sensory
cues. These cues are o en used simultaneously.

 Visual cues may include demonstra ng placement through exaggerated mouth
movements, calling a en on to the mouth or face with hand signals, and/or providing
pictures (e.g., having children simultaneously point to two dots as they say a word with

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